Dikkat eksikliği hiperaktivite bozukluğu tanısı konulan çocuklarda saldırgan davranışları yordayan etkenler
Amaç: Saldırgan davranışlar dikkat eksikliği hiperaktivite bozukluğuna (DEHB) eşlik eden önemli bir gelişimsel sorundur ve DEHB'nin uzun dönemli gidişini etkilemektedir. Bu çalışmada, DEHB'li çocuklarda sosyodemografik değişkenler ve sözel beceri, duygusal yüz ifadesi tanıma becerisi, sosyal karşılıklılık becerisi ve kaygı düzeyi gibi çocuk ile ilişkili değişkenlerinsaldırgan davranışları üzerine etkisinin incelenmesi amaçlanmıştır. Yöntem: Çalışma grubu, bir çocuk psikiyatrisi polikliniğine başvuran ve ilk kez DEHB tanısı konulan 7-11 yaş arasındaki 116 çocuktan oluşturulmuştur. Çocukların değerlendirilmesinde sosyodemografik form, Turgay DSM-IV'e göre Yıkıcı Davranım Bozuklukları Tarama Ölçeği-Ebeveyn Formu (T-DSM-IV-S), Sosyal Cevaplılık Ölçeği (SCÖ), 4-18 yaş Çocuk Ve Gençlerde Davranış Değerlendirme Ölçeği (ÇDDÖ), Çocukluk Çağı Anksiyete Tarama Ölçeği-Ebeveyn Formu (ÇATÖ) ve Gözlerden Akıl Okuma Testi (GAOT) kullanılmıştır. DEHB tanısı bireysel görüşme ile konulup, Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi ile desteklenmiştir. Sonuçlar: Çalışmaya alınan çocukların yaş ortalaması 9.65±2.01 olarak bulunmuştur. Çalışmada ÇATÖ toplam puanı, SCÖ toplam puanı ve T-DSM-IV-S hiperaktivite/impulsivite (H/I) alt ölçek puanının ÇDDÖ saldırgan davranışlar alt ölçek puanı ile ilişkili olduğu saptanmıştır. Çoklu doğrusal regresyon analizinde T-DSM-IV-S H/I alt ölçek puanı, ÇATÖ toplam puanı ve SCÖ toplam puanının sırasıyla saldırgan davranış şiddetini yordayan etkenler olduğu belirlenmiştir. Tartışma: DEHB'li çocuklarda saldırgan belirtiler ortaya çıkmadan yordayıcı etkenlerin sorgulanmasının ve önleyici girişimlerde bulunulmasının bozukluğun gidişini olumlu etkileyeceği düşünülmektedir.
Factors predicting aggressive behaviors in children with attention-deficit/hyperactivity disorder
Objectives: Agressive behaviours are an important associated developmental feature of attention-deficit/hyper-- activity disorder (ADHD) and affect long term prognosis of ADHD. In this study, it's aimed to investigate the impact of sociodemographic variables, and variables related with the child such as verbal skills, the ability to decode facial express/ons, social reciprocity ski/Is and anxiety levels, on aggresive behaviours in children with ADHD. Methods: The study group consisted of 116 children between and 11 year-old, who referred to child psychiatry clinic, and were diagnosed with ADHD for the first time. sociodemographic form, Turgay DSM-IV--Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale T-DSM--I V-Scale)-parent form, Social Reciprocity Scale (SBS), Child Behavior Checklist (CBCL), Screen for Chi/d Anxiety Related Emotional Disorders (SCARED)- parent form, Reading Mind in the Eyes Test were used for assessment. Diagnoses were established based on clinical interview, and supported by the Kiddie Schedule for Affective Disorders and Schizophrenia. Results: The mean age of children were 9.651201. The CBCL aggressive behavior subscale score was correlated with the SCARED-parent form total score, SRS total score, and T-DSM--IV--Scale-parent form hyperactivity/impulsivity (H/l) subscale score. In multiple lineer regression analysis, the three control measures were found to be the predictive factors of aggressive behavior severity, with the mean score of T-DSM--lV-S H/l subscale recording higher beta value than the SCARED Parent Form score, and SRS total score. Discussion: In children with ADHD, it is supposed that investigating the predictive factors, and implementing the prevent/ve interventions before the appearance of aggressive behaviours will improve the prognosis of disorder.
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